A prospective survey on drug choice for prescriptions for admitted patients with schizophrenia

A survey on psychotropic drugs prescribed for the treatment of schizophrenia was implemented in order to obtain basic data required for revision of the Japanese Psychopharmacology Algorithm (1998). The subjects comprised 94 inpatients with schizophrenia (ICD-10) in seven public hospitals. A questionnaire was conducted to record age, gender, age at start of treatment, treatment period, compliance, frequency of admission and diagnostic classification. A mean dose of chlorpromazine base at 420 mg/day was prescribed to the subjects (six men vs four women; mean age: 32.4 years). The average number of psychotropic drugs prescribed together is 4.0 (1.8 for neuroleptics). The mean treatment period is 5.9 weeks. Antiparkinson drugs, hypnotics, anxiolytics, antimanics/antidepressants and antiepileptics are concurrently used in 92, 85, 25, 6.8 and 2.1% of cases, respectively. Prescriptions are changed 1.8 times on the average. In 84% of the patients, good response to the overall treatment is observed. Polypharmacy is carried out in more than 90% of the patients, although clinical psychopharmacological evidence for the benefits or disadvantages of polypharmacy are insufficient. A large-scale survey is required to revise the algorithm for treatment-refractory schizophrenia, because treatment-refractory and long-term hospitalized patients are rarely included in this survey. False intractable cases due to inadequate treatment such as long-term polypharmacy at a high dose may be included when the scope of subjects is enlarged.